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Biomedical subjects

G Avanzi

Publications and source records attributed to G Avanzi.

At least 37 records · Page 2Linked to original sources

Plasma-exchange in myasthenia gravis: a study in 20 patients.

Twenty patients with myasthenia gravis (MG) of generalized 2A and 2B types according to the Ossermann classification were treated with a course of nine plasma exchanges (PE) every two days. Before starting of the course, at the fourth exchange, and at the end of the course, the muscle balance was assessed following a special protocol. Other functions, such as respiratory function, stapedial reflex, phonation, and electro-oculographic activity were assessed and a Desmedt test was done. Three patients showed complete remission of symptoms, 8 showed good improvement and 6 mild improvement. Three showed no improvement. In total 85% of patients gained from PE. The onset of improvement was rapid in all patients but in some it lasted only a short time while in others it persisted for several weeks and even months, without the need for immunosuppressive therapy.

Adult↗

Plasma-exchange in idiopathic radiculopolyneuropathies: a study in 62 patients.

The effectiveness of plasma exchange (PE) in the treatment of acute and chronic idiopathic radioculopolyneuropathies (IR) is discussed on the basis of the literature and personal data. Results of controlled trials by Swedish, French and North American groups are favourable to the use of PE in acute forms, whereas one English group found no significant differences between treated patients and controls. Dick et al. (1986) reported significant improvement also in patients with chronic forms after PE. Personal data from a non-controlled series of 62 acute and chronic IR and from a trial group of 12 acute patients and 12 controls indicated that PE--though helpful in Guillain-Barré syndrome--was not so useful in chronic forms.

Chronic Disease↗

Plasma exchange in myasthenia gravis.

Results obtained with P.E. therapy on 19 myasthenic patients are reported. 15 of them improved during treatment and 4 remained unchanged. We believe P.E. is an useful therapy in M.G. because it produces a rapid improvement in most patients.

Adolescent↗

Plasma exchange in radiculopolyneuropathies.

The AA. report the results obtained with Plasma Exchange (P.E.) therapy on 24 cases of polyradiculoneuritis; eleven patients had typical Guillain-Barré Syndrome (G.B.S.) ten suffered from a chronic progressive form and three were affected by a relapsing form. The acute patients were selected according to criteria established by the NNCDS Committee (1978) while guidelines laid down by Pineas & Load (1978) were followed in choosing chronic cases. Patients with G.B.S. had four sessions of P.E. at intervals of one or two days while those with chronic forms of polyradiculoneuritis had a total of 6 sessions spaced one to three days apart. P.E. produced no apparent change in chronic progressive patients but two out of three cases with the chronic relapsing form showed rapid and steady improvement resulting in complete cure within a few months. Nine of the eleven G.B.S. patients showed after only one or two sessions a clear and rapid improvement which led to a complete cure within a matter of weeks. The remaining 2 cases showed only partial improvement at first and remained stationary thereafter. The findings confirm the usefulness of P.E. in acute and chronic relapsing radiculopolyneuritis. However, potential side effects and the procedure's high cost suggest that its use should be limited to carefully selected cases, and in particular to those involving respiratory disorders.

Acute Disease↗

High dose bolus methylprednisolone for the treatment of acute graft versus host disease.

Nineteen patients with acute graft versus host disease (GvHD) following bone marrow transplantation (BMT) were treated with high dose bolus 6-methylprednisolone (BMPr), at the dose of 20 mg/kg/day i.v. for the first 3 days, 10 mg/kg/day i.v. for the following 4 days, and then at doses gradually tapered down to 1 mg/kg/day. All patients except one, who was given preventive BMPr 5 mg/kg/day i.v. on alternate days, were placed on preventive methotrexate therapy after BMT. Sixteen patients were grafted with an HLA matched, and three patients with an HLA mismatched marrow. Overall complete response rate in the HLA matched group was 43%, with an additional 50% showing a partial response. In the HLA mismatched group there were no responses and all three patients proved refractory to BMPr. With respect to organ involvement the complete and partial response rates were respectively 50% and 33% in the skin, 36% and 28% in the liver, 18% and 55% in the gut. Six of sixteen patients in the HLA matched group and none of the three in the HLA mismatched group are surviving. Thirteen patients died: nine patients for causes directly or indirectly related to GvHD, four of other causes (relapse, rejection, hemorrhage and idiopathic interstitial pneumonia). Side effects of BMPr consisted in hyperglicemia, and steroid associated gastritis in 2/3 of the patients, both of which responded well to conventional treatment. This study indicates that high dose BMPr is an effective form of treatment for established acute GvHD, and has no major side effects. The efficacy of BMPr is less clear in recipients of HLA mismatched grafts.

Adolescent↗

[Hemodilution and plasmapheresis in the therapy of hyperviscosity syndromes].

The results obtained using hemodilution, plasmapheresis, plasma-exchange and erythro-apheresis in the treatment of several diseases with hyperviscosity syndrome are discussed. These therapeutic approaches seem very useful not only in the treatment of hyperviscosity syndrome, but also in the prevention of vascular damage.

Adult↗

Bone marrow transplantation for severe aplastic anemia. A report of 9 cases.

9 patients with severe aplastic anemia (SAA) were treated with bone marrow transplantation (BMT). 5 were conditioned with cyclophosphamide and received and HLA-identical graft (4 patients) or a mismatched graft (1 patient): 1 rejected the graft on day 30 and died on day 34 during conditioning for a second transplant; 1 died on day 15 with acute and severe graft versus host disease (GvHD) in the absence of haemopoietic engraftment; 3 are alive and complete chimeras at 1,069, 490 and 332 days after transplantation. GvHD developed in 4 patients and was treated successfully in 3 with high dose methylprednisolone and/or antilymphocytic globulin (ALG). 4 patients were conditioned with ALG and received bone marrow from a haploidentical sibling or parent: 1 patient was refractory; 3 patients showed evidence of hematologic reconstitution, but 2 of these required a second course of ALG. 3 patients in this group are alive between 60 and 490 days; 1 patient died on day 121 of HBSAg-negative acute hepatitis.

Adolescent↗